Clinical pharmacology of aminocaproic and tranexamic acids

Abstract

<b>Objective/Background:</b> MRI and histopathological reports have demonstrated afferent visual system pathology in Amyotrophic Lateral Sclerosis (ALS). Decreases in contrast visual acuity have also been reported in ALS patients; however, the measurement procedures are prohibitive for large-scale screening. Color vision abnormalities, which can be more easily assessed in clinic, have been associated with visual dysfunction in Parkinson’s Disease and Multiple Sclerosis, but have not been studied in ALS. Our goal is to evaluate color vision as a marker of afferent visual system dysfunction in ALS. This pilot study will compare color vision between ALS patients and visually normal subjects. <b>Methods:</b> Monocular color vision was assessed in ALS subjects (n=25, age 50-80 yrs) and visually normal control subjects (n=25, age 23-89 yrs). All individuals completed the desaturated L’anthony D-15 color test and had a C-index calculated to measure color discrimination (normal 1-1.8). Linear regression was used to fit a model for log C-index as a function of age to the control subjects. An age-adjusted z-score was generated for each ALS patient. <b>Results:</b> 64[percnt] of ALS subjects had impaired color vision (C-index &gt; 1.8). In visually normal control subjects, log C-Index was linearly associated with age (r=0.75, p=0.03). All controls under age 70 had normal color vision; whereas, ALS subjects as young as age 50 demonstrated color deficits. Comparing with our controls and accounting for age, 72[percnt] of ALS subjects had color vision below the 50th percentile, 52[percnt] had color vision below the 25th percentile, and 24[percnt] had color vision below the 10th percentile. <b>Conclusions:</b> Diffuse color discrimination deficits occur in ALS. Color discrimination deteriorates with increasing age in controls but may occur earlier in ALS patients. Further study is needed to confirm these findings and to determine if ALS color abnormalities correlate with disease severity or other markers of neurological dysfunction. <b>Disclosure:</b> Dr. Boven has nothing to disclose. Dr. Jiang has nothing to disclose. Dr. Moss has received personal compensation for activities with Clearview Health partners and Lunbeck as a consultant and from various legal firms as an expert witness.